Actually, I had surgery on my neck even though there was no evidence of nodal involvement from a CT scan or physical exams. I think because there is such a high chance that there can be "occult" neck involvement, the aggressive approach these days is to recommend selective neck dissection anyway. At least that's what my ENT said and what I have read in a couple of articles.

But, Mellay, even if the neck dissection comes back clean, there are other risk factors that can be determined from the pathology report on the tumor that might indicate you should have radiation anyway (this is my case). It's for that reason that it is really worth it to go to a comprehensive cancer center, at least for a second opinion.

There are really two windows for getting a second opinion. The first is before any surgery or anything begins and the second is after surgery when you get the pathology report on the results. If you don't go before the surgery, then it is worth checking with a comprehensive cancer center in that second window about what, if any, treatment is needed after surgery. I would recommend doing this even if your doc says no further treatment is needed. At a CCC they may be aware of some risk factors your doctor is not aware of (also what happened to me sort of).